Peptic Ulcer


A peptic ulcer is a sore that develops in the lining of the lower part of your esophagus, or various parts of your stomach or small intestine.

A peptic ulcer in your esophagus is called an esophageal ulcer. In your stomach, it is called a gastric ulcer.

When the ulcer affects the first part of your small intestine, called the duodenum, it is called a duodenal ulcer.

When you eat, your stomach produces highly acidic digestive juices, also known as stomach acid, to help break down food.

Then, the food passes into your duodenum for further digestion and subsequent absorption into the bloodstream.

To protect your organs from the corrosive effects of stomach acid, a layer of mucus coats the lining of your stomach and duodenum.

When the protective mucus layer breaks down, stomach acid can seep into the lining of your stomach or duodenum and cause an ulcer.

Most peptic ulcers are caused by the bacteria Helicobacter pylori, also known as H. pylori.

Scientists think these bacteria may enter your body through contaminated food or water, or through close contact with an infected person.

Once inside your body, they lodge in the mucus layer of your stomach or duodenum.

As the bacteria grow, they damage the mucus layer, allowing stomach acid to reach the stomach or duodenal lining.

Together, the bacteria and stomach acid cause an ulcer.

Some peptic ulcers are linked to heavy usage of nonsteroidal anti-inflammatory drugs, also known as NSAIDs, including aspirin and ibuprofen.

These drugs reduce the ability of your stomach and duodenum to protect themselves from the effects of stomach acid.

Your doctor may prescribe one or a combination of drugs to treat your peptic ulcer.

If H. pylori is the cause of your ulcer, you will take antibiotics to kill the bacteria.

If your ulcer is due to nonsteroidal anti-inflammatory drugs, your doctor will recommend you stop or limit your use of these drugs.

For a gastric ulcer, you may be given a proton pump inhibitor, also known as a PPI, to decrease acid production in your stomach.

For a duodenal ulcer, you may be given a histamine type-2 receptor antagonist, commonly known as an H2 blocker, to reduce the amount of acid secreted in your stomach.

In addition, your doctor may recommend medications to coat and protect the lining of your stomach and duodenum until the ulcer has healed.

These include: sucralfate, misoprostol, and bismuth subsalicylate, commonly known as Pepto-Bismol.

You may need surgery for an ulcer that does not heal with medication.

Or, you may need surgery for an ulcer that goes away with treatment, then comes back.

You may need an operation for an ulcer that bleeds.

If your ulcer breaks through, or perforates, the wall of your stomach or duodenum, you may need surgery to repair the damage.

You may also need surgery for an ulcer that blocks food from moving out of your stomach.

If you have one or more of these complications, your doctor may recommend one of the following three surgical procedures.

A vagotomy, an antrectomy, or a pyloroplasty.

In a vagotomy, your surgeon will cut part of your vagus nerve.

Through this nerve, your brain tells your stomach to release acid.

After your surgeon cuts the nerve, your stomach will secrete less acid.

In an antrectomy, your surgeon will remove the lower part of your stomach, which is called the antrum.

The antrum signals your stomach to release acid; once it is removed, your stomach releases less acid.

If your ulcer is blocking the exit of food from your stomach, your surgeon may perform a pyloroplasty.

During this procedure, your surgeon will widen the pylorus, which is the opening between your

stomach and duodenum, allowing food to pass through more easily.

While your ulcer heals, you should avoid alcohol and cigarettes,

as they can slow the healing process and may make your ulcer worse.

A few weeks after treatment, your doctor may perform an endoscopy, which is a procedure to

look inside your upper digestive tract to be sure your ulcer has healed.